The predementia stages of Alzheimer's disease (AD) include the stages of asymptomatic stage, subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Among these, SCD and MCI stages are the most clinically actionable windows for recognition and intervention. In recent years, more and more research suggests that non-cognitive symptoms such as depression, anxiety and sleep disorders at this stage are not merely accompanying burdens. They may be closely related to the risk of subsequent cognitive decline, underlying AD pathology and clinical outcomes. These non-cognitive symptoms not only alter individuals' subjective cognitive experience and medical behavior, but may also participate in the formation of early brain fragility through sleep cognitive axis, emotion stress axis and inflammation related pathways. With the emergence of plasma biomarkers such as phosphorylated tau 217 ( ptau217) and advances in neuroimaging as well as risk assessment in the predementia stages of AD is shifting from symptom-based description to integrative evaluation. The integrative evaluation combines the symptom patterns, fluid biomarkers and brain network abnormalities. From the perspective of psychosomatic medicine, this article reviews the clinical status, interaction mechanisms, risk stratification and management progress of depression, anxiety and sleep disorders in the predementia stage of AD. SCD and MCI stages are particularly focused. Moreover, specific emphasis is placed on how non-cognitive symptoms can be reinterpreted from " accompanying phenomena" to prodromal windows. It also attempts to propose a hierarchical management approach based on biological clinical consistency. By integrating psychosomatic symptoms, biomarkers and imaging information, it is expected to provide a more clinically feasible pathway for early identification and dynamic intervention for population in the predementia stage of AD.